Renal Dialysis Clinical Trial
Official title:
Impact of Nurses´ Solution-focused Communication on the Fluid Adherence of Adult Patients on Hemodialysis
Aim: To test the hypothesis that fluid adherence in patients on hemodialysis can be improved
through nurses´ solution-focused communication with patients on issues of adherence.
Design: Single-group quasi-experimental study. Method: A one-month baseline of inter-dialytic
weight gain was taken for a group of 36 adult patients in a hospital hemodialysis unit. Then,
the nurses of the unit received an 5-hour training in solution-focused communication on
issues of fluid adherence and applied it with the patients of the sample. Inter-dialytic
weight gains (IDWG) were measured during another month. Six months after the training, IDWG
was again measured during one month.
Design A single-group quasi-experimental design was carried out. The IDWG was the dependent
variable, expressed as the weight gain in kilograms between dialysis sessions. A base-line
was established by taking IDWG data for one month; after the nurses training, IDWG data were
taken for another month. Follow-up was carried out six months later.
Methods
Participants 36 patients of a hemodialysis unit in a public hospital were invited to
participate in the study. All accepted and gave written informed consent. Nurses were two
women (39 and 37 years old) and one man (30 years old).
The intervention Training. Two two-hour training modules were designed by two recognized
solution-focused therapy experts. In each module, participants watched videos that
illustrated solution-focused communication on fluid adherence, and practiced the skills in
role-plays.
Solution-focused communication on IDWG. In the case of IDWG improvement, nurses were trained
to congratulate the patient and then to explore in detail, from a stance of curiosity, how
nurses had accomplished the weight reduction. Nurses were trained to invite patients to share
specific behavioral details and also to describe their own behavior from the perspective of
significant family members. Nurses were also taught to compliment patients on their
accomplishments and to invite them to keep track of anything else they might find useful to
control fluid intake over the next days.
In the case of IDWG worsening, nurses were encouraged to validate patients´ difficulties and
empathize with their predicament.
A repeated measure analysis of variance (ANOVA) and Student's t were used to analyze the
changes in patient's IDWG over time.
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